| Uscg | |
|
10569 Lake Breeze Dr Seminole FL 33772-4333 | |
| (727) 393-7269 | |
| Not Available |
| Full Name | Uscg |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 10569 Lake Breeze Dr, Seminole, Florida |
| Authorized Official Name and Position | Karen Lynn Gordon (DENTAL HYGIENIST) |
| Authorized Official Contact | 7273937269 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Uscg 10569 Lake Breeze Dr Seminole FL 33772-4333 | Uscg 10569 Lake Breeze Dr Seminole FL 33772-4333 Ph: (727) 393-7269 |
| NPI Number | 1710028048 |
|---|---|
| Provider Enumeration Date | 02/09/2007 |
| Last Update Date | 06/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710028048 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DH19214 (Florida) | Primary |
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